Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
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For FQHCs that are part of a larger organization with multiple practices under the same umbrella, UDS reporting would not meet KM 13 because the data is at the organizational/corporate level. The data for KM 13 must be at the practice level because recognition is at the practice level. An exception to this is for standalone practices whose UDS data is specific to the practice site location.
NCQA Health Plan Medicaid Module is a complementary program designed to support NCQA-Accredited health plans with a Medicaid product line. The combination of the module standards and NCQA Health Plan Accreditation maximize alignment with the Medicaid Managed Care program requirements. This improves a plan’s opportunity to receive a streamlined state compliance review.
NCQA developed the module by analyzing changes to state and federal requirements for the Medicaid Managed Care programs, as outlined in the Medicaid Managed Care Rule.
Organizations must go through a survey and submit documentation to NCQA. The survey score determines certification. See a step-by-step process.
• Certification Process and Timeline: identifies key steps, timing and resources to successfully seek Certification.
• Standards and Guidelines: provides the comprehensive descriptions of the standards, including the intent and the scope of review.
• Interactive Survey Tool: includes the complete standards and guidelines and allows your organization to determine its readiness for a survey by responding to each standard. The tool calculates your survey score.
The first step in earning Certification begins with an overview discussion with an NCQA program expert. Next, you will purchase the program resources, review, conduct a gap analysis and then submit your online application. Next you will align your processes with the standards. Finally, NCQA conducts the survey, creates a report and your Certification status is determined within 30 days of the final review. See a step-by-step process.
The first step to earning accreditation/certification is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.
Align your organization’s processes with the standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.
See a step-by-step process.
If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.
If you do not currently have Physician and Hospital Quality Certification and are interested in learning more, contact NCQA. If you have a current certification and want to talk to someone about current status or about renewing, submit a question through My NCQA.
If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.
